Doctor, Doctor I think I’m a butterfly

The health care we receive, be it NHS/Medicare or care paid for by private insurance, can only be as good as the people providing that care. Doctors & nurses are human, with all the same stresses and worldly cares that we the patients have. It might be troublesome teenagers, aging parents, grief at loss of a loved one or signs & symptoms of their own ill health knocking at their door.

When I was young we had a family GP who worked his practice single handed 24/7. He held two ‘non appointment’ surgeries, five days a week: 2 pm for one hour, and in the evening from six pm to seven thirty, the latter clinic often went on until nine pm, nobody was ever turned away. The remainder of the day was spent making house calls or arranging for hospital admittance or appointments.

DR H, lived along the avenue from us and had his surgery in a converted shed in the garden. It was divided into two rooms (I am going back to the 1950s &60s here).

You opened the outside door and entered the waiting room. A dozen unmatched dining chairs were placed around three walls. A well trodden square of carpet covered the floor and the remaining furniture was a coffee table with a scattering of well thumbed and dog-eared old magazines. Heating was provided by a two bar electric fire.

First patient in plugged in the fire to take the chill off the air, then went and sat next to the internal door to the Doctor’s surgery. Next patient came and sat beside them and soon there was a confessional queue of patients waiting to be seen. As a patient went in to see the Doctor, the others waiting their turn, all stood up as if in unison to move along the row of seats – sure it was good exercise and kept the blood flowing!

The surgery was no more modern than the waiting room. It had an examination table along one wall. On another was a lockable glass cabinet where he kept his few drugs and below it a small wash hand basin. On the floor near his desk and chair was a single gas ring on which sat a saucepan to boil and sterilize his syringes and needles. Finally there were two more chairs for patient and carer and at a safe distance, another two bar electric fire.

How different that all seems to the clinics and surgeries of today:

Appointments to fit our timetable

Touch screen arrival check-ins.

Bright spacious waiting areas with comfortable seating (Thankfully the blasting television screens seem to have been removed).

Bleeping signs that show your name when the Dr is ready to see you.

Digital records and up to date results from X-Rays and hospital visits.

Out of hours doctors panels to deal with emergencies or see urgent cases in their own homes.

GPs today, mostly work in group practice. They spend their day seeing patients in surgery, on house calls or speak to them on the phone. Paper work – be it hard copy or digital – is the major headache and dirty word that they all have to deal with on a daily basis. Letters to Consultants and hospitals. Results of consultations, X-rays or blood tests all need to be read and decisions made. They have stats to fill and targets to meet and at the end of the day about 200 repeat prescriptions to sign. That last one is not as easy as it sounds. Medications that can cause so many complications by being added into the wrong mix – patient charts need checking – drug bibles need checking – eyes get tired, bodies need food, fathers and mothers need to get home and see their families…… They are human!

Many medical procedures are taken care of at the local surgery, or as a day patient in a hospital. Hospital stays are much shorter than in the past. When I had my appendectomy in 1966, the norm was a fourteen day stay in hospital. I was in bed for one full week and ambulatory for the next seven days. Nowadays that operation, like so many others, is most commonly performed as keyhole surgery and the patient discharged in a couple of days.

Today we have vaccines help us avoid:

Flu

HPV (human papilloma virus)

MMR – measles, mumps, rubella

pneumonia

polio

scarlet fever

Typhoid

Whooping cough

Antimalarial prevention comes in tablet form.

Cataracts, hips, knees, hearts, lungs and livers can now be replaced. With the possibility of somatic cell nuclear transfer (SCNT) (taking donated egg cells from women and removing their genetic material. These are then fused with human cells – in this case skin cells – and the fused cell begins behaving in a similar way to an embryo by producing human stem cells) the future holds great possibilities.

Back in August 2009, Ronni Bennett from Time Goes By asked bloggers from both within and without the Unites States of America, to take part in a discussion on how healthy we found our Health Service, and link to her Health Debate on 20th August 2009.

Modern medicine is both wonderful and cruel, amazing advancements have been made over the years, but we have outlandish expectations for miracle cures. We are all living longer and the way the health service works will have to change. Illnesses such as cancer, once considered fatal, are now becoming chronic. Joints and internal organs can be replaced, but there is no such thing as a free lunch… the price is often with (like me) constant reviews and extra medication all costing the state and our pockets to stretch a very long way. We seem to have forgotten that we must die at some stage. I would like to live for another ten to fifteen years, but please don’t keep me hanging on like a vegetable, for another twenty, thirty or forty years, somebody show mercy, open the door and push me outside the igloo!

Over my lifetime, I have witnessed the results of wonderful work both at the hands of public and private health care, but I have seen some dreadful mishaps too from both sides of the coin.

Ah GM – you slyly circumvented the issue by focusing on the providers. Everything you said is true. But you don’t really address the rising costs – simply acknowledge them. Drug companies and trial lawyers – rediculous tort suits over here. Massive debt faced by new docs, And I am in complete agreement – I’ll skip the e4xtra years offered if they be offered as a bedridden burden,

Chuck, the topic was so broad, and as you would see from my linked post: ‘My Tuppenceworth’ I have not had to pay for healthcare, apart from in my taxes, so I decided not to repeat myself so changed my angle, Statistics, like politics, were never my forte.

There are good and bad in every basket. We are in a ME ME ME NOW world, with greed, the god and the rule for so many these days. There are whiners who want five star service for one star cost. There are people who abuse the system and those providing the necessary care. I have always been treated with care and respect. If it is not something life threatening, then I am prepared to wait.

Grannymar, you say “Modern medicine is both wonderful and cruel, amazing advancements have been made over the years, but we have outlandish expectations for miracle cures.”

Couldn’t agree more. Outlandish indeed.

I cannot think of any one profession where demands are being made as they are on doctors. I have read Shackman’s take on the subject – but can’t really follow it. Different contintent, different system, different expectations. Maybe. Who knows. All I know is that I can’t fault the NHS. And that is saying something if you remember that I come from one of the most efficient countries in the world. FOS (father of son) – English – and ever suspicious of the NHS wanted me to go private to give birth. Private? What? Come again? Please do laugh, Grannymar. I did. Still. He who needs to be obeyed I obeyed, for five seconds. So I went for a private consultation. Guess what. Yes. Correct. My PRIVATE consultant was my NHS obstetrician, the god who headed the department at the Royal Victoria Hospital. Oh, did he and I laugh sitting in the privacy of his lovely PRIVATE orchard garden. Saved FOS thousands.

I can say that, in the course of three decades, (with one minor exception – and that was due to a nurse rather than the ‘system’) I have nothing but praise for the National Health Service.

Well, now “everyone” in the USA is supposed to be able to be covered by insurance. If they don’t obtain it, then they are going to be fined. Fine to be assessed and collected by the Internal Revenue Service. The Obamacare law’s official title is the “Affordable Care Act.” It’s more like a financing law than a law that truly addresses health needs and problems with the health care industry.

That’s just it. There is no one system. There are a lot of private players — doctors, hospitals, clinics, insurance companies, pharmaceutical companies, etc. — and I guess they are all loosely connected. But if I want to go to a doctor, I go to that doctor if, and only if, he accepts payments from my insurance company. Same for dental, same for eye-care. But my insurance plan isn’t the same as the fellow’s that live across the street and there are millions that don’t have any insurance at all… but that’s supposed to change.

This is a difficult topic to cover in a comprehensive way. How much health care is enough health care? What effort do individuals make to help themselves, i.e. preventative care? (not smoking, etc.) How much individual responsibility does each of us have to provide our for our own health? (nutrition, exercise, etc.) I wrote a graduate history research paper on the history of the NHS about two years ago. I have read much about health care in the US and other countries too (books and magazines dedicated to specific topics like diabetes). Very interesting subject and huge. Dianne

As you can imagine, this is a hot topic here in the states with Obamacare phasing in. As if it weren’t volatile enough, now the Infernal Revenue Service, which has oversight on it, is now unraveling like a poorly knitted sweater. I’ll let you know how I feel about it if I ever come up before a death panel to determine if I’m worth saving. Frankly, I don’t like my odds.

By the way, I really like your new profile picture and the new header.Where is that taken?

The photo of the tumbling waterfall was taken (by me) in Crawfordsburn Country Park at Helen’s Bay, Co.Down. I noticed I had a date on it for 8th May 2005. My avatar photo was taken by a photo blogger friend called Davy

Canadian Universal Health Care system here, We don’t have a two tier system. So far so good for me. I get discounted drugs because of income level and all health care totally free. And yes I choose my own doctor. And he is great. No death panels yet. But I would love to see euthanasia clinics.
XO
WWW

I’m just very grateful that I’m covered by a health service (NHS) that will give me whatever treatment I need without my having to decide whether I can actually afford it or whether I’ll have to go without. I’ve heard stories of previously well-off middle-class American couples who’re completely bankrupted by unexpected medical treatment and end up homeless and destitute. How can this be possible?

I doubt I can add anything worthy here, BUT the affordable care act is at least a beginning for a more equitable health service here. Too bad some members of the congress refused to make it a single payer system, which would have been so much easier. Our biggest problem here, where I’m concerned, is giving insurance companies too much say in the matter, AND health care should NEVER be a for-profit business venture. My opinion.

What strikes me is the fact, yes fact, that there is no perfect system anywhere in the world. I suppose that at some time in the future we will get a workable model but for the present, we are all bungling our way through many models and not happy with any. Qunatity has taken over from quality and that about sums it all up.